Written by Amber Walker, Owner of Origin Wellness
Amber Walker is a Doctor of Physical Therapy-turned author with a passion to empower others to heal from chronic illness. As the owner of Origin Wellness, Amber utilizes an approach based on a blend of functional/natural medicine, nervous system tools, nutrition, movement, and emotional healing to help patients move from surviving to thriving.
Mast cell activation syndrome (MCAS) is a relatively newly-coined condition that describes the abnormal release of mediators from mast cells in various tissues in the body, often resulting in inflammatory symptoms. This condition could be considered the new irritable bowel syndrome: 1. It is common and becoming increasingly recognized, and 2. It is a (vague) label for inflammation that can be widespread and debilitating.
Research suggests that MCAS and its cellular mechanisms are a part of long-term COVID-19 symptoms. Someone in your close circle is likely already experiencing inflammation from this condition.
When I was diagnosed with MCAS seven years ago, I set out to find out as much as I could about its mechanisms and underlying root causes. At the time, there was not a lot of information published, and I embarked on a several-year process of digging deep to understand it and figure out how to heal it. In the process, I published three books on the topic. Once I uncovered helpful tools and learned how to reverse MCAS, it became my mission to help others heal themselves, too.
At this point, 15 years since MCAS was first described in the literature, my perspective on this condition has shifted quite a bit. I believe that MCAS is a label. Every day in my clinical practice, I see people heal from this and reach a place where symptoms resolve.
When we look under the surface, if we want to simplify things, the main factors that seem to influence it are toxins and the parasites that feed on toxins. Once the body clears toxins, the symptoms and inflammation stop. So, to me, this label is simply one part of the body’s intelligent innate alarm system for when internal balances are off.
Overview
If you’re not familiar with MCAS, let’s summarize the basics. Mast cells are a type of white blood cell found all over the body. As part of the immune system, they can either suppress or add to inflammation. They have receptors for allergens, pathogens, hormones, neuropeptides, and neurotransmitters.
Mast cells contain chemical mediators that they release when signaled, a process called degranulation. There are hundreds of types of chemical mediators, and you may have heard of some of them, like histamine a mediator that’s released during allergic-type reactions.
Environmental toxins, dietary factors, medications, physical/emotional stress, and exposure to invaders (like insect venom, for example) are some sources that may elicit a mediator-release response from these cells.
Symptoms are typically in multiple body systems and tend to be widespread. For some patients, this presents as intolerance to foods, water, medications or supplements, scents and odors, and other chemicals. The skin, eyes, major organs, gastrointestinal, respiratory, genitourinary, neuropsychiatric, and musculoskeletal systems are often impacted. Patients may or may not present with signs of acute allergic reactions and anaphylaxis.
Diagnosis
MCAS falls under the umbrella of a class of conditions called mast cell activation disease (MCAD). Other conditions, such as mastocytosis and certain cancers, also fall under this umbrella but have different mechanisms of action. With MCAS, the body has a normal number of mast cells, but they behave in a hypersensitive manner.
There are few medical practitioners considered experts in this condition (though this is slowly changing), and they tend to order chemical mediator blood or urine tests to try and make the diagnosis, in addition to factoring in symptoms and medication responses.
However, one concern I have with this label is that people may spend a lot of time and resources on trying to capture elevated chemical mediators (like histamine, prostaglandins, tryptase, etc.) to “get the diagnosis,” when instead they could be focusing on the upstream issues responsible for inflammation.
This also breeds the tendency for people to over-identify with the diagnosis/label and demonize the mast cell, which can make it harder to heal in the long run. Often, these patients are gaslit, subjected to medical trauma, and told that things are all in their heads. It’s important to pause and ensure that they feel validated for their suffering while simultaneously understanding that the underlying root issues for this inflammation are fully reversible with the right tools. MCAS is not purely genetic or a condition you must live with or “manage.”
Look upstream
What I find most helpful for these cases is to understand what upstream issues are contributing to this inflammation.
Often, these patients are also diagnosed with a hypermobility spectrum disorder or Ehlers-Danlos syndrome and a type of dysautonomia called POTS (postural orthostatic tachycardia syndrome.) They typically test positive for Lyme disease and other vector-borne coinfections, bacterial dysbiosis and small intestinal bacterial overgrowth, candida or fungal overgrowth, viral infections, and a whole host of other things on functional medicine labs.
However, these other conditions are not the root issue either! Bacterial, fungal, and viral concerns thrive when the general terrain is overrun by toxins. Spot-treating these concerns may or may not provide a shift in symptoms, but what tends to create lasting change for these cases is investigating whether toxins and parasites are playing a role. (For most people, the answer to both—in this modern imperfect world, is an overwhelming yes!)
Bacterial and fungal organisms proliferate naturally as the body’s way to decompose and clear toxins. Parasites feed on toxins and harbor astronomical levels of heavy metals. In addition to heavy metals, patients with MCAS are likely to have elevated mycotoxins (toxins from mold exposure), chemicals like herbicides/pesticides/fungicides, and industrial and environmental toxins in their urine on functional medicine lab testing. Radioactive elements are also a concern. Inhalation, skin contact, and ingestion (food and beverages) are some ways these toxins make it into our systems, which can quickly clog up the exit routes of the skin, lungs, urinary system, and gastrointestinal tract.
Healing from MCAS
The mainstream system jumps to antihistamines and prescription medications for addressing MCAS, which I consider a Band-Aid approach. (However, in some cases, pharmacological approaches help stabilize things initially until the patient can tolerate working on the root issues.)
Another concern I have with the traditional treatment approach is that people may spend a lot of time and resources trying to “stabilize the mast cell” when, instead, they could focus on the upstream issues responsible for inflammation.
Natural herbal supplements such as vitamin C and quercetin may help calm down inflammation initially. However, the most helpful factors early on involve gently opening detoxification and drainage pathways. Addressing constipation is an important starting place, as most people do not realize that they are backed up. Often, this step alone reduces “mast cell” symptoms substantially because the symptoms are from toxins recirculating or getting stuck without an exit route.
A comprehensive plan that integrates detoxification, nutritional considerations, environmental toxin avoidance, emotional healing, structural factors, the lymphatic system, and nervous system/limbic system resources tends to be the most powerful for patients labeled with MCAS.
Hope for the future
If there is anything you take away from this article, it is this: Always look upstream!
MCAS is a genuine and very debilitating condition, but it is also a label for reversible systemic inflammation that needs support. The most important upstream factors are tied to toxins (and the parasites that feed on and harbor toxins).
If you suspect you may be experiencing this condition, seek a well-versed foundational medicine practitioner who can help customize a plan to your unique case. When the body has the right tools, it has an incredible ability to heal itself.
Do not lose hope—the future is bright for MCAS!
Read more from Amber Walker
Amber Walker, Owner of Origin Wellness
Amber Walker is a Doctor of Physical Therapy, author and the owner of Origin Wellness. She is passionate about a root issues approach to healing from chronic illness and has advanced training in functional medicine, nutrition, nervous system healing, Mind Body Spirit Release™ (MBSR™) and CranioBiotic Technique. With over 16 years of experience working with clients all over the world, Amber specializes in conditions such as mast cell activation syndrome, mold biotoxin illness, long Covid, POTS, Ehlers-Danlos syndrome, Lyme disease, autoimmune conditions, and chronic mysterious ailments. When not on a surfboard, she enjoys hosting telehealth groups, 1-on-1 care, and retreats in Mexico. Her mission: Help you go from surviving to thriving.
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